CITY'S MOST PERILOUS DRUG - FENTANYL

"Wit' or wit'out," the usual phrase to order a South Philly
cheesesteak with or without onions, has taken on a deadly new meaning.

Drug dealers are using the expression to ask customers whether they
want illicit heroin - or cocaine - with or without fentanyl, a
synthetic opiate 40 to 100 times more powerful than morphine.

"It's deadly. The push of a syringe is like pulling a trigger," said
U.S. Attorney Patrick Meehan, of the fatal drug mixture that has led
to as many as 70 deaths and up to 220 overdoses in the Philadelphia
and South Jersey area since April.

Fentanyl, the new "drug du jour," has replaced oxycontin as the
primary dangerous drug throughout the city, officials said. Last
Friday, at least 12 abusers overdosed on the deadly mix in Camden,
and it has recently shown up in Harrisburg, Pittsburgh and Delaware.

Yesterday, Meehan, District Attorney Lynne Abraham and others jointly
announced that city, state and federal law-enforcement and
health-care agencies in Philadelphia and South Jersey had banded
together to crack down on what is rapidly emerging as a national
fentanyl crisis.

The top federal and city prosecutors vowed that any drug dealer who
sells fentanyl-laced street drugs that result in death would be
charged with third-degree murder.

Law-enforcement and health-care agencies are reporting known drug
sales, emergency-room drug responses, coroner's reports and other
information to the Philadelphia/Camden High Intensity Drug
Trafficking Area to be analyzed.

Authorities expect to use that intelligence to combat
fentanyl-related street sales, find potential clandestine labs and
reduce drug-related deaths and overdoses.

Abraham said officials debated whether to announce the public-health
warning because it could "perversely" increase deaths and overdoses
by junkies "seeking a bigger bang."

She said she would "not be surprised if people go out and ask for it
by name or content."

These drug addicts "need to be in treatment," said Roland Lamb,
director of addiction services in the city Department of Mental
Health and Retardation.

Drug abusers can get help by calling a toll-free number,
1-888-545-2600, to enter one of 180 drug-treatment or detox
facilities in the area, where an average of 50 beds have been
available in the last year.

Abraham said abusers charged with drug offenses can opt for the
city's drug court as an alternative to trial and enter a treatment
facility as a way to turn their lives around.

Fentanyl is usually prescribed for pain management during surgery and
for chronic pain when morphine no longer works.

But the fentanyl sold here is being manufactured in clandestine drug
labs, said Jack Kassom, special agent-in-charge of the Philadelphia
Drug Enforcement Administration office.

The DEA tied one batch of fentanyl to a Mexican distributor, he
added. Agents are looking at whether the fentanyl sold here came from
a lab shut down on May 20 in Toluca, Mexico, or another clandestine lab.

When abusers buy heroin, they don't know if it is laced with
fentanyl, said Kassom. "People are dying with the needles stuck in
their arms," he said.

The Philadelphia/Camden HIDTA was first to spot the deadly trend in
April, and has since issued four bulletins warning of the emerging drug problem.